Tuesday, January 6, 2015

Revised Abortion Regulation Raises Many Questions

The revised regulation (84-20, Schedule 2) on Medicare funding of abortion in hospitals, and statements by the Minister of Health, raise many questions:

The old regulation required two doctors to certify medical necessity. The new regulation does not mention that even one doctor must do so. Is there no requirement for a doctor to establish medical necessity at all?

Will abortions be performed purely on demand rather than on the basis of medical necessity?

If abortions will be done on demand, why are they not considered electives like other procedures done on the basis of patient wishes (listed in Schedule 2)? And why are taxpayers paying for a procedure that is not medically necessary?

The old regulation stipulated a hospital abortion must be done by a specialist. The new regulation does not mention who must perform the abortion. Is there a requirement that the procedure must be performed by a physician – and if so, where in law is that set down? What would prevent the procedure being performed by a non-physician?

The health minister says he does not expect a spike in the total number of abortions performed in New Brunswick (about 1,000 / year in the past). But when previously 60% of abortions were paid privately (@ $500-800 each), and now all abortions will be free, is it not to be expected that abortion numbers will rise – toward the higher rates seen in Nova Scotia, Newfoundland and other provinces without the type of restrictions NB has had?

The minister estimates that increased abortions expected in hospitals will cost the health care system an additional $500,000-700,000 per year. But is that estimate not based solely on the cost of operating room time ($1,000 / hour for 500-700 additional procedures)? Does it not exclude the additional fees paid to at least three personnel (surgeon, anesthesiologist, pathologist)? Would those fees not increase the additional cost by 50-70% ($1,500-$1,700 / abortion), resulting in total additional costs of $750,000-$1,200,000 per year?

And if the total numbers increase beyond the minister’s expectations [Point 5 above], will not the additional costs be even higher?

NB Right to Life estimates that the additional costs will easily be in the $1,000,000 to $1,500,000 range, and the total abortion costs for Medicare will be at least in the $2,000,000-$3,000,000 range (new costs plus current costs). Those figures do not include the cost of treating post-abortion complications (2-3% of procedures involve immediate physical complications; longer term physical and psychological complications affect many more women, according to much research).

The above questions are surely all legitimate. As New Brunswickers consider the implications of a policy change rightly described as “monumental,” they deserve some answers.